Basic Information
| Provider Information | |||||||||
| NPI: | 1386822617 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUKHARI | ||||||||
| FirstName: | KANEEZE-FATEMA | ||||||||
| MiddleName: | ALTAFHUSEN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11279 PERRY HWY | ||||||||
| Address2: | PINE CENTER, SUITE 450 | ||||||||
| City: | WEXFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150909381 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249331100 | ||||||||
| FaxNumber: | 7249331115 | ||||||||
| Practice Location | |||||||||
| Address1: | 205 MILLERS RUN RD | ||||||||
| Address2: | FIRST FLOOR | ||||||||
| City: | BRIDGEVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150171348 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126923145 | ||||||||
| FaxNumber: | 4126928814 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2008 | ||||||||
| LastUpdateDate: | 07/07/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 002848 | GA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.